A Case of Intussusception Due to a Juvenile Polyp in the Ileum

Abstract

We report a rare case of intussusception due to a juvenile polyp in the ileum. A three-month-old boy was admitted to our hospital because of vomiting, bloody stool, and lethargy one hour before admission. His abdominal ultrasonography showed the target sign at the left upper quadrant. Thus, he was diagnosed as having intussusception, and hydrostatic reduction was attempted. However, operative reduction of the ileo-ileal intussusception was performed because of the failure of hydrostatic reduction. Before the operation, we suspected the possibility of the presence of a pathological lead point because his abdominal sonography showed a 10 mm cystic lesion, including some septa in the center of the target sign. After reduction by Hutchinson’s maneuver, a tumor was found in the lumen of the ileum at 7 cm from the ileocecal valve. Partial resection of the ileum including the tumor was performed. The pathological diagnosis of the tumor was a juvenile polyp that had partial necrosis and destruction of the ileum. Since most juvenile polyps occur in the colon or rectum, cases of colo-colic-type intussusception are common, but those of the ileo-ileal or jejuno-jejunal type are extremely rare. In the Japanese literature, only seven cases of intussusception caused by juvenile polyps in the small intestine have been reported.